Jinks Clare, Jordan Kelvin, Croft Peter
Primary Care Sciences Research Centre, Hornbeam Building, Keele University, Keele, Staffordshire ST5 5BG, UK.
Pain. 2002 Nov;100(1-2):55-64. doi: 10.1016/s0304-3959(02)00239-7.
This study has used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in an unsolicited postal questionnaire to investigate the impact of knee pain and disability in the general older population. The study provides WOMAC population data for those aged over 50 and demographic and psychosocial associations with severity of WOMAC scores. A pilot survey (n=240) and repeatability study (n=80) were undertaken to test completion of the WOMAC in this new setting. The main questionnaire was mailed to 8,995 men and women aged over 50 registered with three general practices in North Staffordshire, UK. Completion rates for WOMAC items were high. Substantial reliability was found for pain and physical function scales (both >0.80). Fourteen percent of the over 50 population in this study had severe knee pain, 20% had severe difficulty with at least one area of physical functioning, 12% had both. The strongest link with severe difficulty with physical functioning was chronicity (odds ratio (OR)=6.49, 95% CI 4.65, 9.04). Other independent links were age over 75 years (odds ratio (OR)=4.11, 95% confidence interval (CI) 3.03, 5.58), depression (OR=2.80, 95% CI 2.22, 3.54), bilateral knee injury (OR=2.23, 95% CI 1.63, 3.06) and body mass index>30 (OR=2.00, 95% CI 1.51, 2.64). Similar associations were found for severe pain. The findings suggest that the WOMAC is a reliable measure for use in postal surveys. It has advantages over other instruments when measuring pain and physical function difficulty related to the knee. Chronicity, older age, injury, obesity and depression were all linked with higher WOMAC scores for knee pain severity and disability among knee pain sufferers in the general older population.
本研究通过一份未经请求的邮政调查问卷，使用了西安大略和麦克马斯特大学骨关节炎指数（WOMAC）来调查膝关节疼痛和残疾对普通老年人群的影响。该研究提供了50岁以上人群的WOMAC数据，以及与WOMAC评分严重程度相关的人口统计学和社会心理因素。进行了一项试点调查（n = 240）和重复性研究（n = 80），以测试在这种新环境下WOMAC的完成情况。主要问卷被邮寄给在英国北斯塔福德郡的三家普通诊所注册的8995名50岁以上的男性和女性。WOMAC项目的完成率很高。疼痛和身体功能量表具有很高的可靠性（两者均>0.80）。本研究中14%的50岁以上人群有严重的膝关节疼痛，20%在至少一个身体功能领域有严重困难，12%两者都有。与身体功能严重困难联系最紧密的是慢性病程（优势比（OR）=6.49，95%置信区间（CI）4.65，9.04）。其他独立相关因素包括75岁以上年龄（优势比（OR）=4.11，95%置信区间（CI）3.03，5.58）、抑郁症（OR = 2.80，95% CI 2.22，3.54）、双侧膝关节损伤（OR = 2.23，95% CI 1.63，3.06）和体重指数>30（OR = 2.00，95% CI 1.51，2.64）。严重疼痛也发现了类似的关联。研究结果表明，WOMAC是用于邮政调查的可靠测量工具。在测量与膝关节相关的疼痛和身体功能困难方面，它比其他工具具有优势。在普通老年人群中，慢性病程、高龄、损伤、肥胖和抑郁症都与膝关节疼痛严重程度和残疾的较高WOMAC评分相关。
